Because people are so attached to their hair (pun intended), a number of myths have sprung up regarding hair — when and

why it goes gray, what causes baldness, and how baldness can be prevented are just a few topics of focus. Wherever people are going bald or worried about losing their hair, myths about hair abound. This chapter turns an objective eye to hair myths so you can separate the serious from the silly when it comes to hair loss.

Hair Loss Comes from Your Mother’s Side

The idea that you inherit a baldness gene only from your mother’s side of the family is a myth. The inheritance of common baldness appears to be found on the autosomal — the non-sex-related — chromosomes, which means that baldness can come from either parent. Moreover, the baldness gene is a dominant gene, meaning that you need only one gene on one chromosome to express the balding trait, although multiple genes appear to influence the balding process.

You can get some insight into baldness by examining balding pat- terns in your relatives. If you have an uncle, father, or grandfather who’s bald or balding, find out when he started to lose his hair; it may be an indication as to when you may go bald. Just don’t put all the blame on Mom if you start to lose your hair. It’s not her fault!

Women also inherit the thinning or balding patterns found in their families, but the patterns that are inherited are distinctly women’s patterns, not men’s pattern. This suggests that the inheritance pat- terns in women do not follow the inheritance patterns in men. Women with hair loss or thinning will frequently report that they take after their mom, grandmother (either side of the family), sister, aunt, etc.

Wearing Hats Causes Hair Loss

More than a few people believe that hats are to blame for baldness based on the idea that hats cut off air circulation to the scalp and prevent the scalp from breathing. What they don’t know is that hair follicles get oxygen from the bloodstream, not the air, so you can’t suffocate your hair follicles just by wearing a hat. The base- ball cap so often worn by men whose hair is thinning doesn’t cause baldness — it hides baldness.

Hats that fit tightly on the head are another story. These hats may cause thinning around the sides of the head where constant traction is applied to the hair. Hats worn all the time for cultural and religious reasons (such as turbans and yarmulkes) may cause hair loss, too. In rare cases, sports helmets have been known to cause traction alopecia in athletes who wear their helmets too often, particularly if the helmet rubs repeatedly against an area of the scalp, causing “traction.”

If You Don’t See Hair in the Drain, You Aren’t Balding You don’t go bald because your hair is falling out; you go bald because your normal, thick hair is gradually being replaced by finer, thinner hair in a process called miniaturization. Yet people who are sensitive to the prospect of going bald often obsessively scrutinize the shower drain and the hairbrush for evidence of impending baldness.

Most people lose about 100 hairs daily but grow another 100 hairs daily to replace what’s lost. Some of the lost hairs wind up in your shower drain or hairbrush, or they may just fall off as you go about your normal activity, responding to whatever your environment dishes out.

Risking it all to cover up

Many of Dr. Rassman’s patients have lived underneath baseball caps for years, never venturing outside without them. The best example is Sam, who was in the shower when the 1994 Northridge earthquake hit in California. Sam never went out without his baseball cap, but when his apartment started to shake, he put a towel around his waist and ran out of the apartment without his baseball hat on. When he reached the street half-naked, Sam realized his head was also naked and immediately ran into the shaking building to retrieve it. He returned to the street still wearing only his towel — but he had his baseball cap!

Dr. Rassman’s office has many Open House events, and Sam comes to many of them to share this story with the audience of prospective hair transplant candidates and to show off his glorious hair. He never wears a baseball cap since finishing his trans- plant reconstruction.

Massive hair loss appearing in the shower drain should alarm you (as should a trail that forms behind you as you walk down the hall!), but insidious, progressive loss may be far more subtle. If progressive loss persists over time, you may lose far more hair than you’ll ever see in the shower drain. This is particularly the case with female hair loss.

Excessive Use of Hair Chemicals and Hot Irons Kills Your Hair

Hair isn’t alive, so hair products or hot irons can’t “kill” hair, although they may cause hair damage. As long as the damage caused by hair products is limited to the hair and not the growing hair follicles below the skin, hair above the skin may be lost from breakage or damage, but it will re-grow from the follicles at a rate of 1⁄2 inch per month.

Damaging hair follicles below the skin, however, can cause bald- ness. When inexperienced people apply chemicals such as unsafe dyes or relaxing agents to the hair and scalp, the caustic chemicals may work their way into the growing part of the hair follicle and damage or kill the hair follicle at its root. The longer powerful chemicals stay on the scalp, the deeper they may penetrate into the pores of the skin where the hair follicles are, resulting in permanent hair loss or hair that may never look “healthy.”

Applying dyes, chemicals, or hot irons (even hair rollers that are too hot) can cause the hair to become fragile and break off. Hair breakage and split ends are most common in people with long hair because the hair is around for a longer amount of time before being cut, so it’s more susceptible to damage from wind, drying, and sunlight as well as chemicals such as relaxers and hair dyes.

Hair Loss Is Caused by Decreased Blood Flow

One hair loss myth says that standing on your head increases the flow of blood to your scalp and thereby improves hair regrowth and regeneration. Although the act may entertain the neighbors and give you a unique look on life (albeit an upside-down one), specialists agree that standing on your head has no impact whatsoever on hair loss. Growing hair does require a significant amount of blood flow, but after you lose hair, blood flow to your scalp decreases because, well, you just don’t need it with no hair up there.

There’s a cause and effect issue here, but it’s important to remember that the hair loss occurs before the blood flow decreases. Decreased blood flow to the scalp isn’t the cause of the hair loss but rather the result of it. The absolute proof of this is that, when good hair is placed into a bald scalp with decreased blood flow, the blood flow returns when the hair starts growing.

Magnets Increase Hair Growth

In the early days of electricity, magnetic devices were commonly sold in local newspapers as a cure for hair loss. Magnetic therapy, a kind of alternative medicine, holds that magnetic fields can yield health benefits by improving blood flow. Backers of the therapy claim that it can be used to treat arthritic joints, circulation problems, and erectile dysfunction.

Over the years, we’ve been asked many times whether magnets can increase hair growth. The answer is a definitive “no.” Even if magnetic fields do affect blood flow — and that’s a dubious proposition — increasing blood flow to the scalp doesn’t prevent hair loss or regenerate hair.

Brushing Your Hair Is Better Than Combing It

When you tug and pull a comb or brush through the tangles and knots in your hair, you may pull out a few hairs, but they’ll grow back because brushing and combing healthy hair doesn’t disturb the hair follicles below the skin surface. Brushing the hair isn’t necessarily better than combing because the real issue is how you brush or comb the particular kind of hair you have. Tugging on knotted hair isn’t good even for healthy hair, but hair that has already started being miniaturized is more susceptible to loss from any kind of rough treatment, including that with a comb or brush.

You’re less likely to damage your hair using a wide-tooth plastic comb or a brush as opposed to a metal comb or one with finer, tighter teeth; these combs tend to be rougher and more traumatic to the hair shaft. When brushing or combing, direct your motion in the direction of hair growth so that the hair shaft (the grain of the hair) is in line with your brushstrokes.

Cutting or Shaving Your Hair Make It Grow Back Thicker

Getting frequent haircuts doesn’t make your hair grow more thickly, but it’s easy to see how this particular myth came about. When hair is cut short, it gets scratchy like sandpaper, and when you run your fingers through this scratchy hair, it seems thicker than it did before. But it’s not thicker — it’s just shorter. Hair grows on average at a rate of a 1⁄2 inch per month. It grows at that rate whether you cut it daily or get a haircut only during leap years on February 29.

Hair Loss Is Caused by Clogged Pores

Many dishonest people claim that clogged pores are the cause of hair loss. Some folks build huge businesses around massaging hair and “treating” the clogged hair follicles to allow the hair to come through the skin. From my experience, people who sell such serv- ices command a healthy price between $200 and 500 per month.

If common baldness were simply due to clogged pores, you wouldn’t need anything more than rigorous shampooing to maintain a full head of hair. But I’m sure you’ve seen men and women who don’t wash their hair often but who don’t seem to have a problem with balding.

Men in particular buy into this clogged pore myth because they feel helpless at watching their hair fall out; when someone tells them that frequent massage and the use of special lotions will free up these clogged pores, they buy into it hook, line, and sinker. Of course, they do get some reward because the head massage feels great.

Frequent Shampooing Causes Hair to Fall Out

When you notice your hair starting to thin, you may blame your shampoo. You notice shed hair in the bathtub or shower and decide to shampoo less often to keep from losing hair. As a result, hair that would normally come out in the bath or shower builds up on the scalp. With the next shampoo, you see even more hair loss, confirming your original suspicion that shampooing causes bald- ness. Thus another hair myth gains footing.

Hereditary baldness isn’t caused by hair falling out but by normal hair gradually being replaced by finer, thinner hair. Shampoo has nothing to do with baldness.

Hair Loss Stops When You Get Older

This myth is partly true because hair loss slows down in men as they age. Usually, men over the age of 60 see only marginal loss, if they have any hair loss at all. For women, the exact opposite is true: with age and the loss of the protective hormone estrogen, women with genetic hair loss find that the hair loss process that starts during menopause gets progressively worse as they age.